Organization
GAIL VANT ZELFDE, PH.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAIL VANT ZELFDE PH.D (OWNER)
(610) 941-0196
Entity
Organization
Contact information
Practice address
158 E BUTLER AVE, SUITE 3, AMBLER, PA 19002-4436
(610) 941-0196
Mailing address
158 E BUTLER AVE, SUITE 3, AMBLER, PA 19002-4436
(610) 941-0196
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS005338L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001661409
AMERIHEALTH
PA
01
—
0261731000
PERSONAL CHOICE
PA
01
—
466001
BLUE CROSS BLUE SHIELD
PA
01
—
487643000
MAGELLAN
PA
01
—
5616328
AETNA
PA
Enumeration date
04/17/2013
Last updated
04/17/2013
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